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Adapted from: Incorporating HIV Prevention into the Medical Care of Persons Living with HIV; Ask ∙ Screen ∙ Intervene - Module 4 Partner Counseling & Referral Services (PCRS). PCRS: What it is and why we need to know. Learning Objectives.
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Adapted from: Incorporating HIV Prevention into the Medical Care of Persons Living with HIV; Ask∙Screen∙Intervene - Module 4 Partner Counseling & Referral Services (PCRS) PCRS: What it is and why we need to know
Learning Objectives Upon completion of training, providers who care for HIV-infected persons will be able to: • DefinePartner Counseling and Referral Services (PCRS) • Explainthe importance of PCRS in relation to HIV • Discussstrategies to include information on PCRS in training for HIV care providers
Quick Poll What comes to mind when you hear the term PCRS?
Breaking the Chain of Infection Clinical Management Behavioral Counseling Partner Services • Make no assumptions • Maintain tact and respect • Use open-ended questions • Ask specific questions • Identify and correct misconceptions • Tailor the intervention • Routinely integrate into clinical encounters
What is HIV Partner Counseling and Referral Services (PCRS)? HIV Partner Counseling and Referral Services: • Is a voluntary and confidential service • Assists persons living with HIV with telling their partner(s) about possible exposure • Facilitates linkages to services • HIV and STDs may be handled differently based on jurisdiction
OVERVIEW OF THE PCRS PROCESS Working w/the HIV-infected Client Locating Partners Working w/Partners 11. FOLLOW UP 1. TRANSITION 10. LINKS TO OTHER SERVICES 2. PARTNER REFERRAL OPTIONS 9. HIV TEST DECISION 3. ELICITATION 4. PARTNER REFERRAL PLAN + COACHING 8. HIV PREVENTION COUNSELING 5. SUMMARY 6. INVESTIGATIVE ACTIVITIES 7. NOTIFICATION
GUIDING PRINICPLES • PCRS is voluntary • Providers must protect confidentiality • Client-centered communication is most effective • PCRS can be implemented at both confidential and anonymous test sites • PCRS is ongoing
Rationale for HIV PCRS HIV PCRS provides an opportunity to: • Interrupt disease transmission and prevent complications • Provide counseling and education for reducing behavioral risks that increase the risk of STD/HIV transmission • Provide access to testing and other prevention services
Partner Counseling, Testing, and Referral in Ten States* with Highest Reported HIV/AIDS Cases in 2002 • Total HIV/AIDS cases = 55,167 • 22% interviewed and partners elicited through PCTRS • Of 14,042 partners elicited • 16% previously known to be HIV+ • Of partners not previously known to be HIV+ • 52 % were tested through PCTRS • 18% of those were newly identified HIV+ *California, Florida, Illinois, Louisiana, New York, New Jersey, North Carolina, Pennsylvania, Texas, Virginia
How Do Patients Feel About Health Department PCRS Provider Referral? • Golden et.al. JAIDS 32: 196-202 2003 • Seattle: surveyed persons w/recently reported HIV • 80% MSM (full article in packet) • Agreed (somewhat/strongly) the health 84% department should routinely offer everyone diagnosed with HIV help in notifying their partners • Would want help notifying at least one 20% partner from the last six months
Strategies for Incorporating PCRS into Training for HIV Providers
Some strategies are: • Practice Sessions • Video • Brain Storm Exercises • Crafting Transitional Phrases • Brown Bag Presentations • Grand Rounds • Handouts/Pamphlets • Post Course Study Guide • Attend Ask, Screen and Intervene Training through the Prevention Training Centers
Post Course Study Guide: Local Reporting Requirements • Laws specific to the clinician • Coordination with private sector for partner services • Protecting confidentiality • Partner notification time frame • Reporting of names/information to other agencies • Management of other jurisdiction requests for partner services • Referrals for additional services
Health Department PCRS Provider Referral • Clinicians often ask how health departments notify partners • Video demonstration of a health department staff confirming the identity of a partner
Health Department PCRS Provider Referral • Video demonstration of notifying a partner of her exposure to HIV
Contact Information • HIV PCRS Training Denise Tafoya, MPA Partner Services Coordinator California STD/HIV Prevention Training Center dtafoya@dhs.ca.gov (562) 570-4371 • Ask, Screen and Intervene Michael D. McElroy, MPH California STD/HIV Prevention Training Center 300 Frank H. Ogawa Plaza, Suite 520 Oakland, CA 94612 mmcelroy@dhs.ca.gov (510) 625-6028 • California HIV PCRS Program Phoenix Smith, MSW Program Director California STD Control Branch psmith@dhs.ca.gov (510) 620-3182